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01.09.2015 | Original Article

Cardiovascular events associated with androgen deprivation therapy in patients with prostate cancer: a systematic review and meta-analysis

verfasst von: Arie Carneiro, Andre Deeke Sasse, Andrew Aurel Wagner, Guilherme Peixoto, André Kataguiri, Ary Serpa Neto, Bianca Alves Vieira Bianco, Peter Chang, Antônio Carlos Lima Pompeo, Marcos Tobias-Machado

Erschienen in: World Journal of Urology | Ausgabe 9/2015

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Abstract

Context

A recently published meta-analysis of randomized clinical trials (RCT) showed that androgen deprivation therapy (ADT) did not significantly increase cardiovascular mortality in prostate cancer patients. However, cardiovascular morbidity, which can impact quality of life, was not evaluated.

Objective

To evaluate the risk of cardiovascular morbidity associated with ADT in patients with prostate cancer.

Methods

We conducted a literature search from January 1960 to June 2012. RCT and large cohort studies that evaluated first-line endocrine therapy and ADT longer than 6 months were screened for inclusion.

Results

In total, 126,898 patients were included in four cohort studies, and 10,760 patients were included in nine RCTs. Analysis of the RCTs showed no differences in the development of acute myocardial infarction (AMI) (OR 1.23; 95 % CI 0.92–1.64; I ²: 0 %) among the patients receiving ADT or not. The analysis of randomized studies that reported other nonfatal cardiovascular events demonstrated a significant increase in such events in the group receiving ADT (OR 1.55; 95 % CI 1.09–2.20; I ²: 0 %). When the large cohort studies were included in the analysis, an increased risk of AMI among men with ADT was found (OR 2.01, 95 % CI 1.90–2.13; I ²: 91,3 %).

Conclusion

The use of ADT in prostate cancer patients corresponded with a significant increase in cardiovascular morbidity associated with AMI and with nonfatal events. Therefore, ADT is linked to a significant negative impact on quality of life. Periodic cardiovascular evaluation is required for these patients.

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Titel: Cardiovascular events associated with androgen deprivation therapy in patients with prostate cancer: a systematic review and meta-analysis
verfasst von: Arie Carneiro
Andre Deeke Sasse
Andrew Aurel Wagner
Guilherme Peixoto
André Kataguiri
Ary Serpa Neto
Bianca Alves Vieira Bianco
Peter Chang
Antônio Carlos Lima Pompeo
Marcos Tobias-Machado
Publikationsdatum: 01.09.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 9/2015
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-014-1439-6

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Context

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Methods

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Conclusion

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